Abstract
ObjectivesTo assess systemic, environmental and lifestyle risk factors for dry eye disease (DED) in a Mediterranean Caucasian population. MethodsA cross-sectional study was performed on 120 Caucasian participants aged between 18 and 89 years (47.0 ± 22.8 years). Medical history, information regarding environmental conditions and lifestyle, Ocular Surface Disease Index, Dry Eye Questionnaire-5, non-Invasive (Oculus Keratograph 5 M) breakup time, tear film osmolarity and ocular surface staining parameters were assessed in a single clinical session to allow DED diagnosis based on the guidelines of the Tear Film and Ocular Surface Society Dry Eye Workshop II Diagnostic Methodology Report. A multivariate logistic regression model was constructed including those variables with a p-value less than 0.15 in the univariate analysis. ResultsA prevalence of 57.7 % for DED was found. No age differences were found between those with and without DED (U = 1886.5, p = 0.243). Nevertheless, the DED group had more females (X2 = 7.033, p = 0.008). The univariate logistic regression identified as potential risk factors for DED the following: female sex, sleep hours per day, menopause, anxiety, systemic rheumatologic disease, use of anxiolytics, daily medication, ocular surgery, poor diet quality, more ultra-processed food in diet, not drinking caffeine and hours of exposure to air conditioning per day. Multivariate logistic regression revealed that hours of sleep per day, menopause and use of anxiolytics were independently associated with DED (p ≤ 0.026 for all). ConclusionsDED is associated with systemic, environmental and lifestyle risk factors. These findings are useful to identify potentially modifiable risk factors, in addition to conventional treatments for DED.
Highlights
According to the Tear Film and Ocular Surface Society Dry Eye Workshop II (TFOS DEWS II), dry eye disease (DED) is defined as a multifactorial disease characterized by the loss of tear film homeostasis, which is accompanied by symptoms of ocular dryness [1]
The TFOS DEWS II Epidemiology Report noted that there is an extensive list of risk factors for DED because the tear film and ocular surface form part of a functional unit, which is influenced by lifestyle, environmental conditions, and systemic and ocular disease [2]
The authors acknowledged the need to study the principal and emerging risk factors of DED following the diagnostic guidelines reported in the TFOS DEWS II Diagnostic Methodology Report [2,5]
Summary
According to the Tear Film and Ocular Surface Society Dry Eye Workshop II (TFOS DEWS II), dry eye disease (DED) is defined as a multifactorial disease characterized by the loss of tear film homeostasis, which is accompanied by symptoms of ocular dryness [1]. DED prevalence ranges from 5 to 50 % at various ages [2,3], impacting quality of life, visual function, ocular healthiness and work productivity of those who suffer from it [1,2]. The TFOS DEWS II Epidemiology Report listed several risk factors for DED [2]. This meta-analysis showed that the prevalence of DED in creases with age, female sex and Asian ethnicity. The authors argued that there is still a considerable lack of information about risk factors for DED and that the implementation of studies to assess such factors in different geographic regions is required
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